先天性心脏病合并肺动脉高压患者血中一氧化氮、内皮素浓度变化及意义

目的：研究内皮素（ＥＴ）和一氧化氮（ＮＯ０在先天性以及病合并肺动脉高压中的病理生理作用。方法：分另用放射免疫分析法和镀铜匐还原法检测了２９例左向右分流先天性心脏病患者血中不同部位（右房ＲＡ、肺动脉主干ＰＡ和右上肺静脉ＰＶ）ＥＴ尝试和反映ＮＯ水平的ＮＯ２＾－／ＮＯ３＾－尝试。其中，合并轻度肺动脉脉高压１０例，中、重度肺动脉高压９例，无肺动脉高压１０例。结果：各部位（ＲＡ、ＰＡ、ＰＶ）ＥＴ浓度：在肺动

WARIATION AND SIGNIFICANCE OF ENDOTHELIN AND NITRIC OXIDE CONCENTRATIONS IN BLOOD FROM WITH CONGENIAL HEART DISEASE ASSOCIATED WITH PULMONARY HYPERTENSION

Objective: To elucidate the pathophysiological significance of endothelin (ET) and nitric oxide (NO) in pulmonary hypertension associated with congenital heart defects. Methods: We measured by copper coated cadmium reduction method in 29 patients with mild pulmonary hypertension; and 10 patients with mild pulmonary hypertension; and 10 patients without pulmonary hypertension. Blood samples were obtained from the right atrium (RA), main pulmonary artery (PA) and right upper pulmonary vein (PV) during operation. Results: Plasma ET concentration group at all sampling sites (p<0.05). The increment of plasma ET concentration from the right atrium to the pulmonary vein was significantly larger in the moderate or severe pulmonary hypertension than in the non-pulmonary hypertension group (p<0.01). The NO2-/NO3- concentrations of sera in the moderate or severe pulmonary hypertension group (p<0.05). No significant difference between the NO2-/NO3- concentrations of sera in the mild pulmonary hypertension group and those in the non pulmonary hypertension group, but plasma ET concentration in the mild pulmonary hypertension group were significantly higher than those in the non-pulmonary hypertension group at all sampling sites. Meantime, the NO2-/NO3- concentrations of sera showed relatively insufficient. Conclusions: All results suggested that the unbalanced ratio of ET and NO may be play a significant role in the pathologic process in patient with congenital heart disease associated with pulmonary hypertension. Plasma ET concentration and serum NO2-/NO3- concentration of the patient could be as a referential data for determined the serious degree of the patient with pulmonary hypertension.